“I’ve got rid of him. I should be all right now.”

I doubt it. She’ll find another one just like the first unless she changes herself. Her problem is in her internal world rather than with anything external.

The Trevor Nunn production of Porgy and Bess, as a musical adapted from the opera, is very moving. The plot is gripping anyway and George Gershwin’s music is as vital as any can be but the show was more than that: it was extremely well done. With a mainly black cast, there would be nothing to choose between an English or American performance. By contrast, when white English orchestras attempt Gershwin’s Rhapsody in Blue it tends to be unconvincing. However, one has to remember that Gershwin himself was white.

One interesting programme note was that one of the black performers has a double first in English and History from Cambridge University. He and the other members of the cast may have a great sense of rhythm but they have a lot more than that. And why ever not? Racial stereotypes are bizarre.

“You’ll die of something else”, said the Consultant Cardiologist.

“Umm… thanks”, I said.

As Camilla Cavendish reports in The Times when referring to The Mental Health Alliance, a group of eighty charities, “These people do heroic work with sufferers and campaign to highlight their needs. But their determination to stamp out stigma could lead them to rewrite reality. Illness has become health. Patients have become clients. Savage attacks on other people have become ‘untoward incidents’.”

She quotes The Department of Health acknowledging that between fifty five and sixty three people (about ten per cent of the total murders) are killed each year by people who have recently been in contact with mental health services. However, she also quotes the charity SANE as believing that at least one in three of the mental illness-associated murders is preventable. The analysis of sixty nine enquiries finds that in half the cases professionals had ignored warnings from family and friends.

He told his mother about various things that other patients had done and he complained that two patients who had befriended him were now coming to the end of their treatment so that he felt abandoned. She cancelled her holiday. She telephoned one or another member of the staff six times in the same evening. The boy certainly achieved his aim of getting his mother into a right tizz so that he has got her on his side against us. His addiction will be very pleased with itself for putting up such a spirited defence.

My Supervisor, Bill, is very tolerant of me. I had so much to tell him today, I rabbited on for most of the hour. I suppose I benefited simply from getting all that pent-up stuff off my chest. My concerns and fears and general negativity tend to get saved up for him. He takes it and then recalibrates me, reassuring me that I really do have some difficult challenges. I leave, feeling refreshed and with my positivity and optimism rekindled

“I’ve had a drink on five occasions in the last month. I don’t seem to be able to get it together. I think it is because I made a poor choice in a new relationship.”

Well, I suppose that’s half the issue. The other half is her own addictive tendency that has led her to make that choice. The primary focus of her attention needs to be on herself rather than on the man. This is the journey of self-exploration that every addict has to travel.

“He’s been at private school. He will never have been exposed to things like that.”

Dear lady, if you believe that, you will believe anything.

She was worried about the results of her cholesterol test. She completely overlooked the results of her liver function tests which showed considerable evidence of the punishment that she has been giving that poor undeserving organ for some time.

I like to tell my patients in my medical practice the joke of the day. Medical practice can be too straight-faced. Humour can be a great healer. Unfortunately, my supply is running low. I depend upon my patients telling me some new jokes in return and nobody has had any recently. We must be living in serious times – too serious.